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Two-period Crossover Study to Demonstrate the Comparability of Pharmacokinetics of Subcutaneous Ianalumab Between 2mL Auto-injector/2mL PFS with1mL Pre-filled Syringe in Adult Participants With Autoimmune Disease

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Novartis

Status and phase

Enrolling
Phase 2

Conditions

Sjögrens Disease
Systemic Lupus Erythematosus
Rheumatoid Arthritis

Treatments

Biological: VAY736 2ml AI
Biological: VAY736 1ml PFS
Biological: VAY736 2 ml PFS

Study type

Interventional

Funder types

Industry

Identifiers

NCT06293365
CVAY736A2202
2023-508996-35-00 (Registry Identifier)

Details and patient eligibility

About

The purpose of this study is to demonstrate the comparability of ianalumab exposure following the sub-cutaneous (s.c.) administration of one injection of 300 mg/2 mL auto-injector (AI) versus two injections of 150 mg/1 mL pre-filled syringe (PFS), and to evaluate the safety and tolerability of ianalumab following the s.c. administration of both devices in participants with rheumatoid arthritis (RA), Sjögren's disease (SjD), or systemic lupus erythematosus (SLE).

A second optional cohort may be included with the objective of demonstrating the comparability of pharmacokinetics of ianalumab between 1 x 2 mL Pre-filled Syringe (PFS) and 2 x 1 mL PFS.

Full description

The study consists of the following periods:

Screening period (up to 4 weeks):

Following the signing of the informed consent, participants will be assessed for eligibility during this period of up to 4 weeks.

Treatment Period 1 + Treatment Period 2, (Week 0 to Week 24):

After completion of the screening period, eligible participants will be randomized at the Baseline visit (Week 0) to one of the 2 treatment sequences (treatment switch at Week 12) in a ratio of 1:1 described below:

  • Cohort 1:

    • Sequence 1: ianalumab 300 mg s.c. (2 x 1 mL PFS) monthly + SoC in Treatment Period 1 and ianalumab 300 mg s.c. (1 x 2 mL AI) monthly + SoC in Treatment Period 2
    • Sequence 2: ianalumab 300 mg s.c. (1 x 2 mL AI) monthly + SoC in Treatment Period 1 and ianalumab 300 mg s.c. (2 x 1 mL PFS) monthly + SoC in Treatment Period 2
  • Cohort 2 (Optional):

    • Sequence 1: ianalumab 300 mg s.c. (2 x 1 mL PFS) monthly + SoC in Treatment Period 1 and ianalumab 300 mg s.c. (1 x 2 mL PFS) monthly + SoC in Treatment Period 2
    • Sequence 2: ianalumab 300 mg s.c. (1 x 2 mL PFS) monthly + SoC in Treatment Period 1 and ianalumab 300 mg s.c. (2 x 1 mL PFS) monthly + SoC in Treatment Period 2 In addition, within each sequence, participants will be further randomized to one of the predetermined injection sites with equal allocation, resulting in a total randomization combination of four (2 sequences x 2 injection sites) for Cohort 1 and six (2 sequences x 3 injection sites) for Cohort 2, respectively.

Extended Treatment period (Week 24 to Week 72): After completion of Week 24 assessment, all participants (who did not discontinue during treatment period) will have the option to enter the extended treatment period to receive ianalumab 300 mg s.c. (Cohort 1: 2 mL AI; Cohort 2: 2 mL PFS) monthly up to Week 68. The end of treatment (EOT) visit will be performed 4 weeks after the last study treatment administration, i.e., at Week 72.

Mandatory Post-Treatment safety follow-up period (from Week 72 to Week 88): Participants who completed the last study treatment or prematurely discontinued from study treatment will enter the post-treatment safety follow-up period.

Conditional Post-Treatment safety follow-up period (from Week 88 to Week 176) Post-treatment follow-up will be performed until B-cell recovery or up to 2 years. B-cell recovery is defined when CD19+ B-cell counts return to >= 50 cells/μL or >= 80% of baseline value, whichever occurs earlier.

Enrollment

140 estimated patients

Sex

All

Ages

18 to 70 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion criteria:

  • Signed informed consent must be obtained before any assessment is performed.
  • Male and female patients aged 18 years to 70 years (inclusive).
  • Body weight at least 35 kg and not more than 150 kg and must have a body mass index (BMI) within the range of 18 - 35 kg/m2. BMI = Body weight (kg) / [Height (m)]2 at screening.
  • Diagnosed with RA, SjD and/or SLE as determined by the investigator.
  • Have active disease (RA, SjD or SLE) that may benefit from B-cell depletion therapy, as determined by the investigator.
  • Participants currently receiving protocol-allowed SoC should be on stable doses of SoC medications for 4 weeks prior to first dosing of study treatment.
  • Ability to communicate well with the investigator, understand and agree to comply with the requirements of the study.

Key Exclusion criteria:

  • Use of prohibited therapies.
  • Active viral, bacterial or other infections requiring systemic treatment at the time of screening or baseline or history of recurrent clinically significant infection.
  • Plans for administration of live vaccines during the study period.
  • Uncontrolled co-existing serious disease.
  • Pregnant or nursing (lactating) women.
  • Women of child-bearing potential (WOCBP), defined as all women physiologically capable of becoming pregnant, refusing or unable to use highly effective methods of contraception while on study treatment and for 6 months after stopping of study drug.
  • US (and other countries, if locally required): sexually active males unless using barrier protection during intercourse with women of child-bearing potential while taking study treatment.

Other protocol-defined inclusion/exclusion criteria may apply.

Trial design

Primary purpose

Basic Science

Allocation

Randomized

Interventional model

Crossover Assignment

Masking

None (Open label)

140 participants in 10 patient groups

Cohort 1: Sequence 1 + Thigh
Experimental group
Description:
Patients randomized to receive injection (2 x 1 mL) PFS in TP1 in Thigh (1 X 2 mL) AI in TP2 in Thigh (1 x 2 mL) AI in ETP in Thigh/ Abdomen
Treatment:
Biological: VAY736 1ml PFS
Biological: VAY736 2ml AI
Cohort 1: Sequence 1 + Abdomen
Experimental group
Description:
Patients randomized to receive injection 1. X 2 mL) AI in TP1 in Abdomen 2. x 1 mL) PFS in TP2 in Abdomen (1 x 2 mL) AI in ETP in Thigh/ Abdomen
Treatment:
Biological: VAY736 1ml PFS
Biological: VAY736 2ml AI
Cohort 1: Sequence 2 + Thigh
Experimental group
Description:
Patients randomized to receive injection (2 x 1 mL) PFS in TP1 in Thigh (1 X 2 mL) AI in TP2 in Thigh (1 x 2 mL) AI in ETP in Thigh/ Abdomen
Treatment:
Biological: VAY736 1ml PFS
Biological: VAY736 2ml AI
Cohort 1: Sequence 2 + Abdomen
Experimental group
Description:
Patients randomized to receive injection 1. X 2 mL) AI in TP1 in Abdomen 2. x 1 mL) PFS in TP2 in Abdomen (1 x 2 mL) AI in ETP in Thigh/ Abdomen
Treatment:
Biological: VAY736 1ml PFS
Biological: VAY736 2ml AI
Cohort 2: Sequence 1 + Thigh
Experimental group
Description:
Patients randomized to receive injection (2 x 1 mL) PFS in TP1 in Thigh (1 X 2 mL) PFS in TP2 in Thigh (1 x 2 mL) PFS in ETP in Thigh/ Abdomen/ Upper Arm
Treatment:
Biological: VAY736 2 ml PFS
Biological: VAY736 1ml PFS
Cohort 2: Sequence 1 + Abdomen
Experimental group
Description:
Patients randomized to receive injection 1. X 2 mL) PFS in TP1 in Abdomen 2. x 1 mL) PFS in TP2 in Abdomen (1 x 2 mL) PFS in ETP in Thigh/ Abdomen/ Upper Arm
Treatment:
Biological: VAY736 2 ml PFS
Biological: VAY736 1ml PFS
Cohort 2: Sequence 1 + Upper Arm
Experimental group
Description:
Patients randomized to receive injection (2 x 1 mL) PFS in TP1 in Upper Arm (1 X 2 mL) PFS in TP2 in Upper Arm (1 x 2 mL) PFS in ETP in Thigh/ Abdomen/ Upper Arm
Treatment:
Biological: VAY736 2 ml PFS
Biological: VAY736 1ml PFS
Cohort 2: Sequence 2 + Thigh
Experimental group
Description:
Patients randomized to receive injection 1. X 2 mL) PFS in TP1 in Thigh 2. x 1 mL) PFS in TP2 in Thigh (1 x 2 mL) PFS in ETP in Thigh/ Abdomen/ Upper Arm
Treatment:
Biological: VAY736 2 ml PFS
Biological: VAY736 1ml PFS
Cohort 2: Sequence 2 + Abdomen
Experimental group
Description:
Patients randomized to receive injection (2 x 1 mL) PFS in TP1 in Abdomen (1 X 2 mL) PFS in TP2 in Abdomen (1 x 2 mL) PFS in ETP in Thigh/ Abdomen/ Upper Arm
Treatment:
Biological: VAY736 2 ml PFS
Biological: VAY736 1ml PFS
Cohort 2: Sequence 2 + Upper Arm
Experimental group
Description:
Patients randomized to receive injection 1. X 2 mL) PFS in TP1 in Upper Arm 2. x 1 mL) PFS in TP2 in Upper Arm (1 x 2 mL) PFS in ETP in Thigh/ Abdomen/ Upper Arm
Treatment:
Biological: VAY736 2 ml PFS
Biological: VAY736 1ml PFS

Trial contacts and locations

20

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Central trial contact

Novartis Pharmaceuticals; Novartis Pharmaceuticals

Data sourced from clinicaltrials.gov

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